13
Recommendation 11
➤ At all stages of palliative care and hospice care in ATC patients,
practitioners should be aware of family systems, and how they affect
patient decision-making. (S-L)
Surgical Management of ATC
Recommendation 12
➤ For patients with confined (stage IVA/IVB) ATC in whom R0/R1 resection
is anticipated, we strongly recommend surgical resection. (S-L)
• Value Statement: The authors for this recommendation placed a higher value for
the benefit (longer overall survival) of surgical resection and placed a lower value
for potential morbidity and subsequent delay in chemotherapy and/or radiation
therapy.
Recommendation 13
➤ Radical resection (including laryngectomy, tracheal resections,
esophageal resections, and/or major vascular or mediastinal
resections) is generally not recommended given the poor prognosis
of ATC and should be considered only very selectively after thorough
discussion by the multidisciplinary team, also considered in light of
new information based upon mutations present and the availability of
targeted therapies. (S-L)
Good Practice Statement 6
➤ If surgery is undertaken, intraoperative frozen section and pathology
consultation may be a helpful adjunct to inform surgical decision-
making. (GPS)
Good Practice Statement 7
➤ In patients without impending airway compromise, we advise against
preemptive tracheostomy placement. (GPS)
